Healthcare Provider Details

I. General information

NPI: 1689625535
Provider Name (Legal Business Name): STEPHANIE LYNN GARRETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 CLIFTON RD NE
ATLANTA GA
30322-4200
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-2700
  • Fax:
Mailing address:
  • Phone: 614-533-6497
  • Fax: 614-566-8737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number39099
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number39099
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: